Miller P F, Bowmer C J, Wheeldon J, Brocklebank J T
Department of Paediatrics and Child Health, St James's University Hospital, Leeds.
Arch Dis Child. 1990 Feb;65(2):196-200. doi: 10.1136/adc.65.2.196.
The pharmacokinetics of prednisolone given intravenously were studied in 11 children with relapsed steroid responsive nephrotic syndrome, and four control subjects. The clearance of both total and unbound drug was decreased in these children and the unbound fraction of the drug in plasma was significantly correlated with the degree of hypoalbuminaemia. We conclude that changes in the clearance of prednisolone and altered protein binding might account for some of the variability in both therapeutic responses and the incidence of toxicity in patients treated with standard dosage regimens.
对11名复发的激素敏感型肾病综合征患儿及4名对照受试者进行了静脉注射泼尼松龙的药代动力学研究。这些患儿体内总药物和游离药物的清除率均降低,且血浆中药物的游离分数与低白蛋白血症程度显著相关。我们得出结论,泼尼松龙清除率的变化及蛋白结合改变可能是导致采用标准剂量方案治疗的患者治疗反应和毒性发生率出现差异的部分原因。